New stories, same Stigma

Framing analysis of news articles about people with alcohol-related conditions needing liver transplants

Bibliographic Data

ID21258005
AuthorsWhitney Langlee (0009-0007-4712-4528, Johns Hopkins University), Divya Kalluri (0000-0001-8118-8591, Johns Hopkins University), Rivka Abedon (0000-0003-2270-1580, Johns Hopkins University), Aura T Teles (0000-0001-8083-6964, Johns Hopkins University), Janetta Brundage (0000-0002-9375-1844, Johns Hopkins University), Po-Hung Chen (0000-0002-9865-1009, Johns Hopkins University), Andrew M Cameron (0000-0002-5810-2398, Johns Hopkins University), Hannah C Sung (0000-0003-4531-2094, Johns Hopkins University), Olivia S Kates (0000-0003-4381-0049, Johns Hopkins University, corresponding author)
Year2025
Volume7
Pages100567
Publication date2025-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSSM - Qualitative Research in Health (JOURNAL)
Journal identifiersISSN: 2667-3215 • E-ISSN: 2667-3215
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.ssmqr.2025.100567
PMID40575725
OpenAlexW4410089079
LanguageEN
Citations received1
References cited32

Background: Public stigma surrounding alcohol use disorder (AUD) negatively impacts people with alcohol-related liver disease (ALD) in need of liver transplants (LT). Representations of LT for ALD are socially constructed in part through media, but media on this topic has been underexplored in current research. Methods: Research team members conducted systematic searches during 7/2022-5/2024 for online, publicly available articles about LT for ALD within leading English-language news sites in the US by monthly visits (n = 24). Using inductive framing analysis, we coded and identified patterns in news articles (n = 42) from 1990 to 2021 to generate frames. Findings: Our inductive analysis generated 4 main frames: (a) making individual exceptions: good people in a bad group, (b) appealing to societal costs: individual actions putting a strain on society, (c) questioning professionals' judgements: doctors' discretionary power, and (d) portraying healthcare as a competition: unfair play in a zero-sum game. Media characterized people with ALD as less deserving of liver transplant, but with individual exceptions. Articles described people with "self-induced" illnesses as irresponsible towards themselves, other LT candidates, and society; doctors as "gatekeepers" with discretionary power over how to apply criteria or rules; and the liver transplant waitlist as a competitive zero-sum game in which people with ALD are or should be deprioritized. Discussion: News articles reflect our society's stigmatization of alcohol-related conditions as well as misconceptions about transplant listing and allocation. Such mischaracterizations can further marginalize stigmatized patients with alcohol-related conditions in need of LTs. We offer recommendations for public communications, including avoiding representations of patients with ALD as exceptions to the norm and contextualizing LT for ALD within the context of public health and social and systemic factors

Psychiatry · Alcohol Consumption and Health Effects · History · Liver Disease and Transplantation · Psychology · Social Psychology · Substance Abuse Treatment and Outcomes

Tools

Open DOIOpen Access